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United States (KaiserHealth) – The Obama administration today unveiled final regulations that detail what information health insurers must provide on new consumer labels mandated by the federal health law to explain their plans. “All consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing,” said Health and Human Services Secretary Kathleen Sebelius in a printed statement. “This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees.” The standardized forms will be available beginning Sept. 23 for about 150 million Americans with private health insurance, federal health officials. The rules set the design for easy-to-understand forms describing health insurance benefits. The forms are intended to provide the same details on all policies using the same language – defined in an accompanying glossary [...] Continue Reading…
Kansas, Oklahoma insurers won’t get a break on rebate rule
Washington, DC, United States (KaiserHealth) – Kansas and Oklahoma are the seventh and eighth states to get the thumbs down from the federal government on their requests to phase in new regulations that could result in health insurance rebates to consumers. Under the Affordable Care Act, companies that sell individual insurance policies must spend at least 80 cents of each premium dollar on health care or quality improvement for their members. Companies that fall short of the 80 percent standard will have to pay rebates to their customers to make up the difference. Kansas Insurance Commissioner Sandy Praeger and Oklahoma Insurance Commissioner John D. Doak had asked the federal Department of Health and Human Services for waivers that would allow the state to slowly phase in the requirement. Both requests were denied Wednesday. HHS official Steve Larsen says he’s seen no evidence that the new requirement [...] Continue Reading…
Despite Deep Opposition, Georgia. Contemplates Healthcare Exchange
Atlanta, GA, United States (KaiserHealth) – ATLANTA—In Georgia, like many other Southern states, opposition to the federal health overhaul runs deep. Yet an overwhelmingly conservative committee of experts carefully, and without rancor, has outlined a plan to give the state a health insurance exchange, a cornerstone of the sweeping health care law passed by Democrats in Congress and signed by President Obama last year. The panel had the blessing of Republican Gov. Nathan Deal, a former U.S. congressman who describes himself as the first House member to denounce the health law as unconstitutional. Georgia has joined 25 other states in a legal challenge to the law likely to be resolved by the Supreme Court. But if the 2010 health law is not overturned by the court or repealed, states will have two choices—comply with the law, or wait for the federal government to force it on them. [...] Continue Reading…
Premiums, Deductibles And Cost Sharing In Employer Health Plans Keep Rising
Washington, DC, United States (KaiserHealth) – Signing up for health insurance during your company’s annual enrollment period, which for many plans is right now, may feel like taking a nasty dose of medicine: You know it’s good for you, but it sure doesn’t go down easy. On the plus side, nearly two-thirds of companies are still offering health insurance to their employees, according to the Kaiser Family Foundation’s annual survey of employer health benefits. That’s worth a lot. But that coverage won’t come cheap, as premiums, deductibles and cost sharing continue to rise, sometimes even more steeply than in previous years. More employers are also moving to high-deductible plans that shift increasing expenses onto their employees, requiring them to pay more before benefits kick in. And companies are making it pricier to insure spouses and children. There is a bright spot, however: Employees who participate in [...] Continue Reading…
Insurance broker wants a slice of pizza parlor industry
Diane Alter – AHN News Reporter
San Ramon, CA, United States (AHN) – Roughly 3 billion pizza pies are sold in the United States every year from the 61,269 pizza parlors around the country. So it shouldn’t be surprising that an insurance company has designed a policy to protect parlor owners and their drivers. California-based EPIC Programs wants a “Slice” of the $30 billion pizza industry. The “Safety, Loss Control, Insurance, Coverage, Expertise,” program, available in 40 states, addresses liabilities pizza parlor owners face from their delivery drivers. The program is underwritten by an unnamed insurer that specials in auto coverage. It includes mandatory driver training, education and other risk measures. Industry websites state that delivery drivers own insurance policies that do not cover them when they are delivering food for their employers. Pizzerias take out excess coverage on their employees’ behalf as a result. Pizza [...] Continue Reading…
Four U.S. insurers to provide data on health care costs
Vittorio Hernandez – AHN News
Washington, DC, United States (AHN) – Four large health insurers in the U.S. have agreed to provide data on more than 5 million medical claims to researchers in order to better understand the soaring cost of health care. The Health Care Cost Institute, a newly-formed nonprofit group, will study information provided by Aetna, Humana, Kaiser Permanent and United Health Group. UnitedHealth Group Executive Vice President Simon Stevens said the insurer decided to share data with the institute to achieve greater transparency behind the unstoppable rise in health care costs. The institute would make available to qualified researchers the data from the four insurers and release twice a year summaries on changes in health care prices and use of medical services, according to Martin Gaynor, chairman of the institute’s governing board. Medicare has previously opened its data to researchers on the condition [...] Continue Reading…
Changes To Medigap Plans Meet Resistance
Washington, DC, United States (KaiserHealth) – A provision of the 2010 federal health law seeking to increase Medicare beneficiaries’ share of health care costs is meeting resistance from an unlikely group of 33 state insurance regulators, health insurers and consumer advocates charged with revising Medigap insurance policies that cover most out-of-pocket expenses. The National Association of Insurance Commissioners assembled the group to come up with ways to raise the beneficiaries’ cost for the most popular and generous Medigap policies, a task Congress assigned to the association in the health law. Since then, the idea of shifting some costs to beneficiaries in Medigap policies has emerged as one of several proposals to reduce the federal deficit. The proposals suggest that if Medigap policies cover less of beneficiaries’ costs, some seniors will be less likely to overuse Medicare-covered health care services. The Congressional Budget Office estimated in March that [...] Continue Reading…
Insurers See Growing Risks As Well As Revenues In Medicaid Managed Care
Washington, DC, United States (KaiserHealth) – McALLEN, Texas – Sanjuanita Espinoza, 55, doesn’t seem like a gold mine for private insurers. She’s disabled, has high blood pressure and has no family to help with her care. Yet, to some Texas insurers, she is an opportunity. In August, the state picked five health plans in South Texas to oversee care for people such as Espinoza who are enrolled in Medicaid, the state-federal program for the poor. This scenario is playing out across the country as states increasingly turn to private insurers to rein in the cost of Medicaid. But Medicaid managed care is a risky business. Many new enrollees are older and sicker than the people health plans typically cover. The political environment is fierce, and insurers face resistance from doctors, hospitals and perhaps patients. About 100 Medicaid enrollees – most of whom will soon enroll in [...] Continue Reading…
